Kortne Custer, P.A. -C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5601005349 Issued in MI

Practice address

555 Midtowne St NE
Grand Rapids, MI 49503-5729

Phone

(616) 588-8880

NPI assigned

Sep 26, 2008

Last updated

Jan 9, 2015By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1222387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420761600000",
    "number": "1881844777",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3140 HALL ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495063171",
            "telephone_number": "616-634-9195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 MIDTOWNE ST NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495035729",
            "telephone_number": "616-588-8880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUSTER",
        "first_name": "KORTNE",
        "credential": "P.A. -C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-26",
        "last_updated": "2015-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601005349",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Joy Curyto, PH.D.
• Sabrina Cusenza, CTRS
• Julie Lynn Cusic, LMSW
• Kellee Cusick, LMSW
• Jacqueline R Custer
• Larry Andrew Custer, R.PH.
• Carey Cutcher, LMSW
• Brian Scott Cutler, DO
• Leah Remi Cutler, LLMSW
• Cutlerville Eyecare, P.C.

• Physician Assistant in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.